Federal regulations require states to review service plans for beneficiaries of the Medicaid program, ensure that service providers are qualified, and have a system to track abuse, neglect and exploitation by those who work in the beneficiaries' homes.

Pennsylvania failed on all three counts, according to the report, which said that seven of 25 states analyzed did not have adequate systems in place to monitor the quality of care. Pennsylvania's deficiencies were for a program that had 7,000 beneficiaries in 2009, according to the Inspector General's Office.

It was one of three states that had failed to correct problems several years after they were first noticed by the Center for Medicare and Medicaid Services, the federal agency that administers the government insurance programs. The other states were Colorado and Wisconsin.

The Pennsylvania deficiencies were first cited in 2007. The state had a plan to fix the problems, the report said, but as of early 2011 it was still unable to prove, for example, "that it could monitor whether beneficiaries were receiving all of the services identified in their services plans."

The report did not name Pennsylvania or the other states, but the Office of Inspector General said Pennsylvania was one of the three states with the most persistent problems.

Carey Miller, spokeswoman for the Pennsylvania Department of Public Welfare, which oversees the state's Medicaid programs said, “We have no comment.

Under the Corbett administration, the department has stepped up efforts to eliminate Medicaid waste, fraud, and abuse.